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Cost-effectiveness of on-demand rFVIIa vs prophylactic emicizumab in hemophilia a with inhibitors: clinical, QoL, and ICER-based field insights
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Abstract<sec> <title>Objective

To evaluate the cost-effectiveness of emicizumab compared to recombinant activated factor VII (rFVIIa) in Iraqi patients with hemophilia A and inhibitors.

Method

A retrospective cost-effectiveness analysis was conducted on 46 male patients with hemophilia A and inhibitors treated at a public children’s hospital in Baghdad. Data collection was conducted between November 2024 and March 2025. Clinical and economic data were retrospectively collected for a 12-month follow-up for each of rFVIIa and then emicizumab, including bleeding episodes, emergency visits, treatment costs, and health-related quality of life assessed via EQ-5D-5L (adults) and EQ-5D-Y-3 L proxy (children). Quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios were calculated.

Results

Emicizumab improved mean utility scores from 0.10 to 1.00 in children and from 0.32 to 0.89 in adults, corresponding to an incremental cost of –$2726.36 and –$4304.78 per QALY, respectively (indicating cost savings). Annual bleeding episodes dropped from 8.70 to 0, saving $282.04 per episode. Hospitalization costs decreased significantly, resulting in a total saving of $286650.41 per hospitalization prevented. Use of emicizumab also reduced overall healthcare resource utilization, eliminating emergency department visits, and minimizing diagnostic procedures.

Conclusion

Emicizumab delivers substantial clinical and economic benefits over rFVIIa. Its capacity to enhance quality of life while reducing treatment costs positions it as a cost-effective option for adults and children with hemophilia A and inhibitors in resource-constrained settings. Health authorities should prioritize emicizumab over rFVIIa for patients with hemophilia A and inhibitors, due to its superior efficacy and cost-effectiveness.

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Publication Date
Thu Dec 30 2021
Journal Name
Al-kindy College Medical Journal
Clinical Analysis of Four Maternity Deaths in Iraq by COVID-19
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This study aims to identify maternal death cases caused by Coronavirus infection 2019 pneumonia, including disease progression, fetal consequences, and the fatality cause.

Patients and methodology: A retrospective case collection of Iraqi pregnant women in their second and third trimesters diagnosed with COVID-19 pneumonia and died due to it.

The four cases were all of a young age, had a brief complaint period, and had no comorbidities. Fever, dyspnea, and fatigue were the most common symptoms. Hypoxia was present in all cases and was the cause of mortality in three cases, with thromboembolism being a potential cause in the fourth. Prelabour membrane breakup, fetal growth restriction, and fetal death are al

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Publication Date
Fri May 31 2024
Journal Name
Research Journal Of Biotechnology
The Utility of SHBG Assay in Clinical Biochemistry for Iraqi Women
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Polycystic ovarian syndrome, additionally called PCOS is the most widespread endocrine illness amongst women. The aetiology of PCOS is attributed to a multi-factorial interplay among environmental and genetic effects. The overarching goal evaluates the correlation among blood concentrations of total testosterone, sex-hormone-binding globulin (SHBG), estradiol (E2), follicle-stimulating hormone (FSH) and luteinizing hormone (LH) in ladies with PCOS and the impact of obesity, age, marital popularity on the obtained results. This study was conducted at the National Center for Educational Laborites /Medical City/ Baghdad. The study comprised of a sample of 83 women, elderly between 17 -45 years, who had been selected in a random manner

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Publication Date
Mon Jun 01 2015
Journal Name
. International Journal Of Computer Science And Mobile Computing
A Hybrid Lossy Image Compression based on Wavelet Transform, Polynomial Approximation Model, Bit Plane Slicing and Absolute Moment Block Truncation
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Publication Date
Mon Jun 01 2020
Journal Name
Iop Conference Series: Materials Science And Engineering
On Bayesian Estimation of System Reliability in Stress – Strength Model Based on Generalized Inverse Rayleigh Distribution
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Abstract<p>The parameter and system reliability in stress-strength model are estimated in this paper when the system contains several parallel components that have strengths subjects to common stress in case when the stress and strengths follow Generalized Inverse Rayleigh distribution by using different Bayesian estimation methods. Monte Carlo simulation introduced to compare among the proposal methods based on the Mean squared Error criteria.</p>
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Publication Date
Mon Mar 15 2021
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of an Educational Program on Female Students’ Knowledge toward Premenstrual Syndrome in Secondary Schools in Third Al- Rusafa Education Directorate, Iraq
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Objective: To evaluate the effectiveness of educational program on female students’ knowledge toward premenstrual syndrome.
Methodology: A quasi-experimental design study conducing on (140) student purposely in four secondary schools at Al-sadder city (70) student for study group and (70) for control group. The prevalence of PMS selected through American College of Obstetricians and Gynecologists (ACOG) (2015) criterias to select PMS students before program. The education program were set in four steps, the first step (pre-test) is to assess the knowledge , before the implementation of the program, the second step is implementing the program, following two steps post-test I and II between each test two weeks. Validity is determined

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Publication Date
Thu Jun 30 2022
Journal Name
Journal Of Economics And Administrative Sciences
The Effectiveness of Monetary Policy in Neutralizing Oil Price Fluctuations on the Gross Domestic Product in Iraq for the Period (1990-2019)
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The research aimed to measure the reality of monetary policy and its role in neutralizing the impact of fluctuations in total domestic oil prices, through the most important monetary policy variable (money supply). An example of this is using a simple technique in the previous example, turning it into a straightforward user interface by (Judd and Kunee). After estimating the impact of the policy with the domestic gross domestic oil prices in Iraq, the effect of fluctuations in the domestic gross domestic oil prices in the simple regression model, while the morale of oil prices was not proven with a negative sign, while the morale of money supply and their impact on the increase of the domestic was proven in the multiple regressio

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Publication Date
Thu Sep 05 2019
Journal Name
Journal Of Engineering / University Of Baghdad
Subsurface Water Retention a Technology for Increasing the Field Use Efficiency and Water Saving Values of Cucumber Plant
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The technology of subsurface soil water retention (SWRT) uses a polyethylene trough that is fixed under the root zone of the plant. It is a modern technology to increase the values of water use efficiency, plant productivity and saving irrigation water by applying as little irrigation water as possible. This study work aims at improving the crop yield and water use efficiency of a cucumber plant with less applied irrigation water by installing membrane trough below the soil surface. The field experiment was conducted in the Hawr Rajab District of Baghdad Governorate in Winter 2018 for testing various trickle irrigation systems. Two agricultural treatment plots were utilized in a greenhouse for the comparison. Plot T1 has used a subsurface t

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Publication Date
Wed Aug 28 2019
Journal Name
Journal Of Engineering
Subsurface Water Retention a Technology for Increasing the Field Use Efficiency and Water Saving Values of Cucumber Plant
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The technology of subsurface soil water retention (SWRT) uses a polyethylene ‎trough that is fixed under the root zone of the plant. It is a modern technology to increase the values of water ‎use efficiency, plant productivity and saving irrigation water by applying as little irrigation water ‎as possible. This study work aims at improving the crop yield and water use efficiency of a cucumber plant with less applied irrigation water by installing membrane trough below the soil surface. The field experiment was conducted in the Hawr Rajab District of ‎Baghdad Governorate in Winter 2018 for testing various trickle irrigation ‎systems. Two agricultural ‎treatment plots were utilized in a greenhouse for the compa

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Publication Date
Sun Aug 31 2014
Journal Name
Arabian Journal Of Geosciences
Petroleum system modeling and risk assessments of Ad’daimah oil field: a case study from Mesan Governorate, south Iraq
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Publication Date
Sun Sep 22 2019
Journal Name
Baghdad Science Journal
Detection of CTX-M-type ESBLs from Escherichia coli Clinical Isolates from a Tertiary Hospital, Malaysia
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The present study aims to detect CTX-M-type ESBL from Escherichia coli clinical isolates and to analyze their antibotic susceptibility patterns. One hundred of E. coli isolates were collected from different clinical samples from a tertiary hospital. ESBL positivity was determined by the disk diffusion method. PCR used for amplification of CTX-M-type ESBL produced by E. coli. Out of 100 E. coli isolates, twenty-four isolates (24%) were ESBL-producers. E. coli isolated from pus was the most frequent clinical specimen that produced ESBL (41.66%) followed by urine (34.21%), respiratory (22.23%), and blood (19.05%).  After PCR amplification of these 24 isolates, 10 (41.66%) isolates were found to possess CTX-M genes. The CTX-M type ESBL

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